3.24.13. Employment Tax Returns

(1)

Service Center (SC) Block Control

ABC

(auto)

The screen displays the Alphanumeric Block Control (ABC) entered in the Entry Operator (EOP) Dialog Window. It cannot be changed.

(2)

Block Document Locator Number (DLN)

DLN

(auto)

Enter the first 11 digits from:

1. Form 813 — the "Block DLN" box.

2. Form 1332 — the "Document Locator Number" box.

3. Form 3893 — Box 2.

(3)

Batch Number

BATCH

<Enter>

Enter the batch number from:

1. Form 813 or Form 1332 — the "Batch Control Number" box.

2. Form 3893 — Box 3.

(4)

Document Count

COUNT

<Enter>

Enter the document count from:

1. Form 813 or Form 1332 — the circled serial number. If a full block (100 documents) or if a number is not circled, enter 100.

2. Form 3893 — Box 4.

(5)

Pre-journalized Credit Amount

CR

<Enter>

Enter the amount in dollars and cents from:

1. Form 813 — shown as the "Total" or "Adjusted Total."

2. Form 3893 — Box 5.

(6)

Filling

<Enter>

Press <Enter> five times.

(7)

Source Code

SOURCE

<Enter>

If the control document is Form 3893, enter from Box 11 as follows:

1. R = "Reprocessable" box checked.

2. N = "Reinput of Unpostable" box checked.

3. 4 = "SC Reinput" (Service Code) box checked.

Note: If none of the boxes are checked, consult your supervisor to determine if a source code is needed.

If any other control document, press <Enter>

(8)

Year Digit

YEAR

<Enter>

If the control document is Form 3893, enter the digit from Box 12. If any other control document, press <Enter>.
This is a MUST ENTER field if the Source Code is "R", "N", or "4".

(9)

Filling

<Enter>

Press <Enter> Only.

(10)

Remittance Processing System (RPS) Indicator

RPS

<Enter>

Enter a "2" if:

1. "RPS" (Remittance Processing System) is edited or stamped in the upper center margin of Form 813 or Form 1332or "RRPS" (Residual Remittance Processing System) is in the header of Form 1332.

2. Box 13 is checked on Form 3893.

(1)

Section Number

SECT:

Section "01" is always generated. No entry is needed.

(2)

DLN Serial Number

SER#

<Enter>

• Enter the last two digits of the 13-digit DLN from the upper part of the form.

• If the serial number generated by the system, verify that it matches the document being entered.

(3)

Check Digit

CD

<Enter>

Press <Enter>.

(4)

Name Control

NC

<Enter>

Enter the Name Control.
Refer to IRM 3.24.38.3.4.14.3, Determining the Name Control, for complete instructions.

(5)

Employer Identification Number

EIN

Enter the EIN from the "Employer Identification Number (EIN)" boxes.

(6)

Address Check

ADDRESS CHECK?

Enter "Y" or "N" as appropriate.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(7)

Street Key

STREET KEY

<Enter>

Enter the Street Key.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(8)

ZIP Key

ZIP KEY

<Enter>

Enter the ZIP Key.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(9)

Tax Period

TAXPR

<Enter>
★★★★★★

Enter the Tax Period as:

1. Edited above the "Report for this Quarter.../Informe para este trimestre..." (Form 941 and Form 941-SS / Form 941(PR)) box.

2. Checked by the taxpayer in the "Report for this Quarter.../Informe para este trimestre..." (Form 941 and Form 941-SS / Form 941(PR)) box. Use the last two digits of the Form Year located in the upper left corner of the return (YY) with the checked box as follows:

   1. For Reporting Quarter January through March, enter as YY03.

   2. For Reporting Quarter April through June, enter as YY06.

   3. For Reporting Quarter July through September, enter as YY09.

   4. For Reporting Quarter October through December, enter as YY12.

3. If multiple boxes in the "Report for this Quarter.../Informe para este trimestre..." (Form 941 and Form 941-SS/ Form 941(PR)) box are checked, and the Tax Period is not edited above the "Report for this Quarter.../Informe para este trimestre..." (Form 941 and Form 941-SS / Form 941(PR)) box, enter the earliest quarter checked.

4. If Tax Period is missing or incomplete, process as current quarter.

(10)

In-Care-of Name Line

C/O NAME

<Enter>

Enter the In-Care-of Name immediately following the % or C/O indicator on the document if present.
Refer to IRM 3.24.38.3.4.14.7, In Care of Name, for complete instructions.

(11)

Foreign Address

FGN ADD

<Enter>

Enter the Foreign Address information as shown or edited from the entity area.
Refer to IRM 3.24.38.3.4.14.9, Foreign Address, for complete instructions.

(12)

Street Address

ADD

<Enter>

Enter the Street Address information as shown or edited from the Address box in the entity area.
Refer to IRM 3.24.38.3.4.14.8, Street Address, for complete instructions.

(13)

City

CITY

<Enter>

Enter the City from the City box in the entity area or the Major City Code (MCC) as appropriate.
Refer to IRM 3.24.38.3.4.14.10, City, for complete instructions.

(14)

State

ST

<Enter>

Enter the standard State abbreviation from the State box in the entity area. If a Major City Code is entered, this field is bypassed.
Refer to IRM 3.24.38.3.4.14.11, State, for complete instructions.

(15)

ZIP Code

ZIP

<Enter>

Enter the ZIP Code from the ZIP Code box in the entity area.
Refer to IRM 3.24.38.3.4.14.12, ZIP Code, for complete instructions.

(16)

Return Code

RET CD

<Enter>

For Form 941 only: If "95" or "96" is edited in the top right corner of Page 1 of the return, enter the edited "95" or "96"; otherwise, press <Enter>.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "02".

(2)

Computer Condition Code

CCC

<Enter>

Enter the edited, stamped or underlined code(s) from the space to the right of the phrase "You MUST complete all 3 pages of Form 941 and SIGN IT" /"TIENE que completar las tres páginas del Formulario 941-PR y FIRMARLO".

(3)

Schedule Indicator Code

SIC

<Enter>

Enter the edited digit from the right margin near the black title bar for Part 1.

(4)

Received Date

RDT

<Enter>

Enter the date as stamped or edited on the face of the return.

(5)

ERS (Error Resolution System) Action Code

ERS

<Enter>

Enter the edited digits from the bottom left corner of Page 1.

(6)

P/I Code

P&I

<Enter>

Enter the edited code from the right margin near Line 11.

(7)

FTD Penalty

FTDPEN

<Enter>

Enter the edited amount to the right of the "Report for this Quarter.../Informe para este trimestre..." (Form 941 and Form 941-SS / Form 941(PR)) box.

(8)

Schedule R Indicator

SRI

<Enter>

If present, enter the edited "R" from the right margin of Line 7.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if a Pre-journalized Credit Amount (prompt "CR") was entered in the Block Header.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

1. If number is not numeric, input as numeric (two input as 2).

2. If number is larger than seven numerics, leave blank.

3. If number is in dollars and cents (123.00), leave blank.

4. If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

5. If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qual. Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qual. Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L11D

<Enter>

Enter the amount from Line 11d.

(22)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(23)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(24)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L13C

<Enter>

Enter the amount from Line 13c.

(25)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L13E

<Enter>

Enter the amount from Line 13e.

(26)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(27)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(28)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(29)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2 / Mes 2" box or Line 16 in Part 2.

(30)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box or Line 16 in Part 2.

(31)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages Taken Before April 1, 2021

L19

<Enter>

Enter the amount from Line 19.

(32)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages taken before April 1, 2021

L20

<Enter>

Enter the amount from Line 20.

(33)

Qualified Sick Leave Wages Taken After March 31, 2021, and before October 1, 2021

L23

<Enter>

Enter the amount from Line 23.

(34)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages on Line 23

L24

<Enter>

Enter the amount from Line 24.

(35)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Sick Leave Wages on Line 23

L25

<Enter>

Enter the amount from Line 25.

(36)

Qualified Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L26

<Enter>

Enter the amount from Line 26.

(37)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages on Line 26

L27

<Enter>

Enter the amount from Line 27.

(38)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Family Leave Wages on Line 26

L28

<Enter>

Enter the amount from Line 28.

(39)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(40)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(41)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(42)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(43)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if a Pre-journalized Credit Amount (prompt "CR") was entered in the Block Header.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

1. If number is not numeric, input as numeric (two input as 2).

2. If number is larger than seven numerics, leave blank.

3. If number is in dollars and cents (123.00), leave blank.

4. If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

5. If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qual. Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qual. Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L11D

<Enter>

Enter the amount from Line 11d.

(22)

Nonrefundable Portion of COBRA Premium Assistance Credit

L11E

<Enter>

Enter the amount from Line 11e.

(23)

Number of Individuals Provided COBRA Premium Assistance

L11F

<Enter>

Enter the number of individuals from Line 11f.

1. If number is not numeric, input as numeric (two input as 2).

2. If number is larger than seven numerics, leave blank.

3. If number is in dollars and cents (123.00), leave blank.

4. If the number is followed by a comma, in the wrong position, leave blank (1, 2, 3 would be left blank but 1,000 would be input as 1000).

5. If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(24)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(25)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(26)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L13C

<Enter>

Enter the amount from Line 13c.

(27)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L13E

<Enter>

Enter the amount from Line 13e.

(28)

Refundable Portion of COBRA Premium Assistance Credit

L13F

<Enter>

Enter the amount from Line 13f.

(29)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(30)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(31)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(32)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2/ Mes 2" box for Line 16 in Part 2.

(33)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(34)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages Taken Before April 1, 2021

L19

<Enter>

Enter the amount from Line 19.

(35)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages taken before April 1, 2021

L20

<Enter>

Enter the amount from Line 20.

(36)

Qualified Sick Leave Wages Taken After March 31, 2021, and before October 1, 2021

L23

<Enter>

Enter the amount from Line 23.

(37)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages on Line 23

L24

<Enter>

Enter the amount from Line 24.

(38)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Sick Leave Wages on Line 23

L25

<Enter>

Enter the amount from Line 25.

(39)

Qualified Family Leave Wages Taken After March 31, 2021, and before October 1, 2021

L26

<Enter>

Enter the amount from Line 26.

(40)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages on Line 26

L27

<Enter>

Enter the amount from Line 27.

(41)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Family Leave Wages on Line 26

L28

<Enter>

Enter the amount from Line 28.

(42)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(43)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(44)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(45)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(46)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if a Pre-journalized Credit Amount (prompt "CR") was entered in the Block Header.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

1. If number is not numeric, input as numeric (two input as 2).

2. If number is larger than seven numerics, leave blank.

3. If number is in dollars and cents (123.00), leave blank.

4. If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

5. If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qual. Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qual. Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Employee Retention Credit

L11C

<Enter>

Enter the amount from Line 11c.

(22)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021

L11D

<Enter>

Enter the amount from Line 11d.

(23)

Nonrefundable Portion of COBRA Premium Assistance Credit

L11E

<Enter>

Enter the amount from Line 11e.

(24)

Number of Individuals Provided COBRA Premium Assistance

L11F

<Enter>

Enter the number of individuals from Line 11f.

1. If number is not numeric, input as numeric (two input as 2).

2. If number is larger than seven numerics, leave blank.

3. If number is in dollars and cents (123.00), leave blank.

4. If the number is followed by a comma, in the wrong position, leave blank (1, 2, 3 would be left blank but 1,000 would be input as 1000).

5. If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(25)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(26)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(27)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken Before April 1, 2021

L13C

<Enter>

Enter the amount from Line 13c.

(28)

Refundable Portion of Employee Retention Credit

L13D

<Enter>

Enter the amount from Line 13d.

(29)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages Taken After March 31, 2021

L13E

<Enter>

Enter the amount from Line 13e.

(30)

Refundable Portion of COBRA Premium Assistance Credit

L13F

<Enter>

Enter the amount from Line 13f.

(31)

Total Advance Received from Filing Form(s) 7200 for the Quarter

L13H

<Enter>

Enter the amount from Line 13h.

(32)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(33)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(34)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(35)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2/ Mes 2" box for Line 16 in Part 2.

(36)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(37)

Line 18b Check Box

18BCKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(38)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages Taken Before April 1, 2021

L19

<Enter>

Enter the amount from Line 19.

(39)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages taken before April 1, 2021

L20

<Enter>

Enter the amount from Line 20.

(40)

Qualified Wages for the Employee Retention Credit

L21

<Enter>

Enter the amount from Line 21.

(41)

Qualified Health Plan Expenses

L22

<Enter>

Enter the amount from Line 22.

(42)

Qualified Sick Leave Wages Taken After March 31, 2021

L23

<Enter>

Enter the amount from Line 23.

(43)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages on Line 23

L24

<Enter>

Enter the amount from Line 24.

(44)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Sick Leave Wages on Line 23

L25

<Enter>

Enter the amount from Line 25.

(45)

Qualified Family Leave Wages Taken After March 31, 2021

L26

<Enter>

Enter the amount from Line 26.

(46)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages on Line 26

L27

<Enter>

Enter the amount from Line 27.

(47)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Family Leave Wages on Line 26

L28

<Enter>

Enter the amount from Line 28.

(48)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(49)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(50)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(51)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(52)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if a Pre-journalized Credit Amount (prompt "CR") was entered in the Block Header.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qual. Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qual. Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Employee Retention Credit

L11C

<Enter>

Enter the amount from Line 11c.

(22)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(23)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(24)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages

L13C

<Enter>

Enter the amount from Line 13c.

(25)

Refundable Portion of Employee Retention Credit

L13D

<Enter>

Enter the amount from Line 13d.

(26)

Total Advance Received from Filing Form(s) 7200 for the Quarter

L13F

<Enter>

Enter the amount from Line 13f.

(27)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(28)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(29)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(30)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2/ Mes 2" box for Line 16 in Part 2.

(31)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(32)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages

L19

<Enter>

Enter the amount from Line 19.

(33)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages

L20

<Enter>

Enter the amount from Line 20.

(34)

Qualified Wages for the Employee Retention Credit

L21

<Enter>

Enter the amount from Line 21.

(35)

Qualified Health Plan Expenses Allocable to Wages Reported on Line 21

L22

<Enter>

Enter the amount from Line 22.

(36)

Credit from Form 5884-C, Line 11, for this Quarter

L23

<Enter>

Enter the amount from Line 23.

(37)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(38)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(39)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(40)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(41)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if a Pre-journalized Credit Amount (prompt "CR") was entered in the Block Header.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the Line is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qualified Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qualified Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Employee Retention Credit

L11C

<Enter>

Enter the amount from Line 11c.

(22)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(23)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(24)

Deferred Amount of Social Security Tax

L13B

<Enter>

Enter the amount from Line 13b.

(25)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages

L13C

<Enter>

Enter the amount from Line 13c.

(26)

Refundable Portion of Employee Retention Credit

L13D

<Enter>

Enter the amount from Line 13d.

(27)

Total Advance Received from Filing Form(s) 7200 for the Quarter

L13F

<Enter>

Enter the amount from Line 13f.

(28)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press<-> (Minus).

(29)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(30)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(31)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2 / Mes 2" box for Line 16 in Part 2.

(32)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(33)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages

L19

<Enter>

Enter the amount from Line 19.

(34)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages

L20

<Enter>

Enter the amount from Line 20.

(35)

Qualified Wages for the Employee Retention Credit

L21

<Enter>

Enter the amount from Line 21.

(36)

Qualified Health Plan Expenses Allocable to Wages Reported on Line 21

L22

<Enter>

Enter the amount from Line 22.

(37)

Credit from Form 5884-C, Line 11, for this Quarter

L23

<Enter>

Enter the amount from Line 23.

(38)

Deferred Amount of the Employee Share of Social Security Tax Not Withheld and Included on Line 13b

L24

<Enter>

Enter the amount from Line 24.

(39)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(40)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(41)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(42)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(43)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if the "CR" prompt (Element 5, Pre-journalized Credit Amount) contains an entry.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Qualified Sick Leave Wages

L5AI

<Enter>

Enter the amount from Line 5a(i), column 1.

(9)

Qualified Family Leave Wages

L5AII

<Enter>

Enter the amount from Line 5a(ii), column 1.

(10)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(11)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(12)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(13)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(14)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(15)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(16)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(17)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(18)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(19)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11A

<Enter>

Enter the amount from Line 11a.

(20)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Wages

L11B

<Enter>

Enter the amount from Line 11b.

(21)

Nonrefundable Portion of Employee Retention Credit

L11C

<Enter>

Enter the amount from Line 11c.

(22)

Total Taxes after Adjustments and Nonrefundable Credits

L12

<Enter>

Enter the amount from Line 12.

(23)

Total Deposits

L13A

<Enter>

Enter the amount from Line 13a.

(24)

Deferred Amount of Employer’s Share of Social Security Tax

L13B

<Enter>

Enter the amount from Line 13b.

(25)

Refundable Portion of Credit for Qualified Sick and Family Leave Wages

L13C

<Enter>

Enter the amount from Line 13c.

(26)

Refundable Portion of Employee Retention Credit

L13D

<Enter>

Enter the amount from Line 13d.

(27)

Total Advance Received from Filing Form(s) 7200 for the Quarter

L13F

<Enter>

Enter the amount from Line 13f.

(28)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(29)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(30)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(31)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2 / Mes 2" box for Line 16 in Part 2.

(32)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(33)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Wages

L19

<Enter>

Enter the amount from Line 19.

(34)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Wages

L20

<Enter>

Enter the amount from Line 20.

(35)

Qualified Wages for the Employee Retention Credit

L21

<Enter>

Enter the amount from Line 21.

(36)

Qualified Health Plan Expenses Allocable to Wages Reported on Line 21

L22

<Enter>

Enter the amount from Line 22.

(37)

Credit from Form 5884-C, Line 11, for this Quarter

L23

<Enter>

Enter the amount from Line 23.

(38)

Qualified Wages Paid March 13 through March 31, 2020, for the Employee Retention Credit

L24

<Enter>

Enter the amount from Line 24.

(39)

Qualified Health Plan Expenses Allocable to Wages Reported on Line 24

L25

<Enter>

Enter the amount from Line 25.

(40)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(41)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(42)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(43)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(44)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if the "CR" prompt (Element 5, Pre-journalized Credit Amount) contains an entry.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(9)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(10)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(11)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(12)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(13)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(14)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(15)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(16)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(17)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

L11

<Enter>

Enter the amount from Line 11.

(18)

Total Taxes after Adjustments

L12

<Enter>

Enter the amount from Line 12.

(19)

Total Deposits

L13

<Enter>

Enter the amount from Line 13.

(20)

Balance Due / Overpayment

14/15

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 14 or Line 15 as follows:

1. If the amount in Line 14 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 14 is different from the Remittance amount, enter the amount from Line 14 and press <Enter>.

3. If there is no entry in Line 14, enter the amount from Line 15 and press <-> (Minus).

(21)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(22)

Tax Liability Month 1

16-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(23)

Tax Liability Month 2

16-2

<Enter>

Enter the amount from the "Month 2 / Mes 2" box for Line 16 in Part 2.

(24)

Tax Liability Month 3

16-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(25)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked otherwise, press <Enter>.

(26)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(27)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(28)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(29)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if the "CR" prompt (Element 5, Pre-journalized Credit Amount) contains an entry.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Number of Employees

LN1

<Enter>

Enter the number of employees from Line 1.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank. (1, 2, 3 would be left blank but 1,000 would be input as 1000)

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(4)

Total Wages/Tips plus Other Compensation

LN2

<Enter>

Enter the amount from Line 2.

(5)

Total Income Tax Withheld

LN3

<Enter>

Enter the amount from Line 3.

(6)

Line 4 Check Box

4CKBX

<Enter>

Enter a "1" if the box is checked; otherwise, press <Enter>.

(7)

Taxable Social Security Wages

L5A

<Enter>

Enter the amount from Line 5a, column 1.

(8)

Taxable Social Security Tips

L5B

<Enter>

Enter the amount from Line 5b, column 1.

(9)

Taxable Medicare Wages and Tips

L5C

<Enter>

Enter the amount from Line 5c, column 1.

(10)

Additional Taxable Medicare Wages and Tips

L5D

<Enter>

Enter the amount from Line 5d, column 1.

(11)

Total Social Security and Medicare Taxes

L5E

<Enter>

Enter the amount from Line 5e.

(12)

Section 3121(q) Notice of Demand-Tax Due on Unreported Tips

L5F

<Enter>

Enter the amount from Line 5f.

(13)

Total Taxes Before Adjustments

LN6

<Enter>
Minus <->

Enter the amount from Line 6.

(14)

Adjustment to Fractions of Cents

LN7

<Enter>
Minus <->

Enter the amount from Line 7.

(15)

Adjustment to Sick Pay

LN8

<Enter>
Minus <->

Enter the amount from Line 8.

(16)

Adjustment to Current Quarter's Tips and Group-Term Life Insurance

LN9

<Enter>
Minus <->

Enter the amount from Line 9.

(17)

Total Taxes after Adjustments

L10

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 10.

(18)

Total Deposits

L11

<Enter>

Enter the amount from Line 11.

(19)

Balance Due / Overpayment

12/13

<Enter>
Minus <->
★★★★★★

Enter the amount from Line 12 or Line 13 as follows:

1. If the amount in Line 12 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount in Line 12 is different from the Remittance amount, enter the amount from Line 12 and press <Enter>.

3. If there is no entry in Line 12, enter the amount from Line 13 and press <-> (Minus).

(20)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund / Envie un reembolso" box is checked; otherwise, press <Enter>.

(21)

Tax Liability Month 1

14-1

<Enter>

Enter the amount from the "Month 1 / Mes 1" box for Line 16 in Part 2.

(22)

Tax Liability Month 2

14-2

<Enter>

Enter the amount from the "Month 2 / Mes 2" box for Line 16 in Part 2.

(23)

Tax Liability Month 3

14-3

<Enter>

Enter the amount from the "Month 3 / Mes 3" box for Line 16 in Part 2.

(24)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes / Sí" box in Part 4 is checked; otherwise, press <Enter>.

(25)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(26)

Preparer's PTIN

PTIN

<Enter>

Enter the Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(27)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(28)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

If already present on the screen, press <Enter>; otherwise, enter the proper Section as listed below:

• "04" = Month 1/Mes 1

• "05" = Month 2/Mes 2

• "06" = Month 3/Mes 3

(2) through (32)

Tax Liability

LN1 through L31

<Enter>
★★★★★★

Enter the amounts from the Report of Tax Liability (ROFTL) for Semiweekly Schedule Depositors/ Registro de la Obligación Contributiva para los Depositantes de Itinerario Bisemanal, Lines 1 through 31.

(1)

Section Number

SECT:

Section "01" is always generated. No entry is needed.

(2)

DLN Serial Number

SER#

<Enter>

• Enter the last two digits of the 13-digit DLN from the upper part of the form.

• If the serial number generated by the system, verify that it matches the document being entered.

(3)

Check Digit

CD

<Enter>

Press <Enter>.

(4)

Name Control

NC

<Enter>

Enter the Name Control.
Refer to IRM 3.24.38.3.4.14.3, Determining the Name Control, for complete instructions.

(5)

Employer Identification Number

EIN

Enter the EIN from the "Employer Identification Number (EIN)" box.

(6)

Address Check

ADDRESS CHECK?

Enter "Y" or "N" as appropriate.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(7)

Street Key

STREET KEY

<Enter>

Enter the Street Key.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(8)

ZIP Key

ZIP KEY

<Enter>

Enter the ZIP Key.
Refer to IRM 3.24.38.3.4.5.1, Enhanced-Entity Index File (E-EIF) Check, for complete instructions.

(9)

Tax Year

YR

<Enter>

Enter the Tax Year in YY format as:

1. Edited in the upper right corner of the form.

2. If the Tax Year is not edited, enter the last two digits of the preprinted Tax Year located in the upper right corner of the form.

(10)

In-Care-of Name Line

C/O NAME

<Enter>

Enter the In-Care-of Name immediately following the % or C/O indicator on the document if present.
Refer to IRM 3.24.38.3.4.14.7, In Care of Name, for complete instructions.

(11)

Foreign Address

FGN ADD

<Enter>

Enter the Foreign Address information as shown or edited from the entity area.
Refer to IRM 3.24.38.3.4.14.9, Foreign Address, for complete instructions.

(12)

Street Address

ADD

<Enter>

Enter the Street Address information as shown or edited from the Address box in the entity area.
Refer to IRM 3.24.38.3.4.14.8, Street Address, for complete instructions.

(13)

City

CITY

<Enter>

Enter the City from the City box in the entity area or the Major City Code (MCC) as appropriate.
Refer to IRM 3.24.38.3.4.14.10, City, for complete instructions.

(14)

State

ST

<Enter>

Enter the standard State abbreviation from the State box in the entity area. If a Major City Code is entered, this field is bypassed.
Refer to IRM 3.24.38.3.4.14.11, State, for complete instructions.

(15)

ZIP Code

ZIP

<Enter>

Enter the ZIP Code from the ZIP code box in the entity area.
Refer to IRM 3.24.38.3.4.14.12, ZIP Code, for complete instructions.

(16)

Computer Condition Codes

CCC

<Enter>

Enter the edited code(s) from the center bottom margin.

(17)

Received Date

RDT

<Enter>

Enter the date as stamped or edited on the face of the return or as printed by a cash register in the upper right corner of the return.

(18)

ERS-Action Code

ERS

<Enter>

Enter the edited digits from the bottom left corner of Page 1.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "03".

(2)

Remittance Amount

RMT

<Enter>

This is a MUST ENTER field if the "CR" prompt (Element 5, Pre-journalized Credit Amount) contains an entry.

1. Enter the green rockered amount from the balance due area of the return or from an attached cash register receipt.

2. If no amount is edited or the edited amount is illegible, check the Form 813 control document for the correct amount.

(3)

Tier 1 Employer Tax -Compensation (other than tips and sick pay)

$1

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 1. (Line 1a on the 2010 Form Revision)

(4)

Tier 1 Employer Medicare Tax -Compensation (other than tips and sick pay)

$2

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 2.

(5)

Tier 2 Employer Tax -Compensation (other than tips)

$3

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 3.

(6)

Tier 1 Employee Tax -Compensation (other than sick pay)

$4

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 4.

(7)

Tier 1 Employee Medicare Tax -Compensation (other than sick pay)

$5

<Enter>
★★★★★★

Enter the compensation amount to the right of the dollar sign ($) on Line 5.

(8)

Tier 1 Employee Additional Medicare Tax - Compensation (other than sick pay)

$6

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 6.

(9)

Tier 2 Employee Tax -Compensation

$7

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 7. (Line 7a on the 2010 Form Revision)

(10)

Tier 1 Employer Tax - Sick Pay

$8

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 8.

(11)

Tier 1 Employer Medicare Tax - Sick Pay

$9

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 9.

(12)

Tier 1 Employee Tax -Sick Pay

$10

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 10.

(13)

Tier 1 Employee Medicare Tax - Sick Pay

$11

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 11.

(14)

Tier 1 Employee Additional Medicare Tax - Sick Pay

$12

<Enter>

Enter the compensation amount to the right of the dollar sign ($) on Line 12.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "04".

(2)

Adjustments to Employer and Employee Railroad Retirement Taxes Based on Compensation

L14

<Enter>
Minus <->

Enter the amount from Line 14.

(3)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation taken before April 1, 2021

L16

<Enter>

Enter the amount from Line 16.

(4)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation Taken After March 31, 2021

L17B

<Enter>

Enter the amount from Line 17b.

(5)

Total Taxes after Adjustments and Nonrefundable Credits

L19

<Enter>
Minus <->

Enter the amount from Line 19.

(6)

Total Railroad Retirement Tax Deposits for the Year

L20

<Enter>

Enter the amount from Line 20.

(7)

Refundable Portion of Credit for Qualified Sick and Family Leave Compensation for Leave Taken Before April 1, 2021

L23

<Enter>

Enter the amount from Line 23.

(8)

Refundable Portion of Credit for Qualified Sick and Family Leave Compensation for Leave Taken After March 31, 2021

L24B

<Enter>

Enter the amount from Line 24b.

(9)

Balance Due / Overpayment

28/29

<Enter>
Minus <->

Enter the amount from Line 28 or Line 29 as follows:

1. If the amount on Line 28 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount on Line 28 is different from the Remittance amount, enter the amount from Line 28 and press <Enter>.

3. If there is no entry on Line 28, enter the amount from Line 29 and press <-> (Minus).

(10)

Qualified Sick Leave Compensation for Leave Taken Before April 1, 2021

L30

<Enter>

Enter the amount from Line 30.

(11)

Qualified Health Plan Expenses Allocable to Compensation Reported on Line 30

L31

<Enter>

Enter the amount from Line 31.

(12)

Qualified Family Leave Compensation for Leave Taken Before April 1, 2021

L32

<Enter>

Enter the amount from Line 32.

(13)

Qualified Health Plan Expenses Allocable to Compensation Reported on Line 32

L33

<Enter>

Enter the amount from Line 33.

(14)

Qualified Sick Leave Compensation for Leave Taken After March 31, 2021

L36

<Enter>

Enter the amount from Line 36.

(15)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Compensation Reported on Line 36

L37

<Enter>

Enter the amount from Line 37.

(16)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Sick Leave Compensation Reported on Line 36

L38

<Enter>

Enter the amount from Line 38.

(17)

Qualified Family Leave Compensation for Leave Taken After March 31, 2021

L39

<Enter>

Enter the amount from Line 39.

(18)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Compensation Reported on Line 39

L40

<Enter>

Enter the amount from Line 40.

(19)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Family Leave Compensation Reported on Line 39

L41

<Enter>

Enter the amount from Line 41.

(20)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund" box is checked; otherwise, press <Enter>.

(21)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes" box is checked; otherwise, press <Enter>.

(22)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(23)

Preparer's PTIN

PTIN

<Enter>

Enter the Paid Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(24)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(25)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "04".

(2)

Adjustments to Employer and Employee Railroad Retirement Taxes Based on Compensation

L14

<Enter>
Minus <->

Enter the amount from Line 14.

(3)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation taken before April 1, 2021

L16

<Enter>

Enter the amount from Line 16.

(4)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation Taken After March 31, 2021

L17B

<Enter>

Enter the amount from Line 17b.

(5)

Nonrefundable Portion of COBRA Premium Assistance Credit

L17C

<Enter>

Enter the amount from Line 17c.

(6)

Number of Individuals Provided COBRA Premium Assistance

L17D

<Enter>

Enter the number of individuals from Line 17d.

• If number is not numeric, input as numeric (two input as 2).

• If number is larger than seven numerics, leave blank.

• If number is in dollars and cents (123.00), leave blank.

• If the number is followed by a comma, in the wrong position, leave blank (1, 2, 3 would be left blank but 1,000 would be input as 1000).

• If number is illegible refer to IRM 3.24.38.3.4.7, Illegible Data, for complete instructions.

(7)

Total Taxes after Adjustments and Nonrefundable Credits

L19

<Enter>
Minus <->

Enter the amount from Line 19.

(8)

Total Railroad Retirement Tax Deposits for the Year

L20

<Enter>

Enter the amount from Line 20.

(9)

Refundable Portion of Credit for Qualified Sick and Family Leave Compensation for Leave Taken Before April 1, 2021

L23

<Enter>

Enter the amount from Line 23.

(10)

Refundable Portion of Credit for Qualified Sick and Family Leave Compensation for Leave Taken After March 31, 2021

L24B

<Enter>

Enter the amount from Line 24b.

(11)

Refundable Portion of COBRA Premium Assistance Credit

L24C

<Enter>

Enter the amount from Line 24c.

(12)

Balance Due / Overpayment

28/29

<Enter>
Minus <->

Enter the amount from Line 28 or Line 29 as follows:

1. If the amount on Line 28 is the same as the Remittance amount, enter a "0" (zero) and press <Enter>.

2. If the amount on Line 28 is different from the Remittance amount, enter the amount from Line 28 and press <Enter>.

3. If there is no entry on Line 28, enter the amount from Line 29 and press <-> (Minus).

(13)

Qualified Sick Leave Compensation for Leave Taken Before April 1, 2021

L30

<Enter>

Enter the amount from Line 30.

(14)

Qualified Health Plan Expenses Allocable to Compensation Reported on Line 30

L31

<Enter>

Enter the amount from Line 31.

(15)

Qualified Family Leave Compensation for Leave Taken Before April 1, 2021

L32

<Enter>

Enter the amount from Line 32.

(16)

Qualified Health Plan Expenses Allocable to Compensation Reported on Line 32

L33

<Enter>

Enter the amount from Line 33.

(17)

Qualified Sick Leave Compensation for Leave Taken After March 31, 2021

L36

<Enter>

Enter the amount from Line 36.

(18)

Qualified Health Plan Expenses Allocable to Qualified Sick Leave Compensation Reported on Line 36

L37

<Enter>

Enter the amount from Line 37.

(19)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Sick Leave Compensation Reported on Line 36

L38

<Enter>

Enter the amount from Line 38.

(20)

Qualified Family Leave Compensation for Leave Taken After March 31, 2021

L39

<Enter>

Enter the amount from Line 39.

(21)

Qualified Health Plan Expenses Allocable to Qualified Family Leave Compensation Reported on Line 39

L40

<Enter>

Enter the amount from Line 40.

(22)

Amounts Under Certain Collectively Bargained Agreements Allocable to Qualified Family Leave Compensation Reported on Line 39

L41

<Enter>

Enter the amount from Line 41.

(23)

Refund Indicator

RI

<Enter>

Enter a "2" if ONLY the "Send a Refund" box is checked; otherwise, press <Enter>.

(24)

Third-Party Designee Check Box

CKBX

<Enter>

Enter a "1" if only the "Yes" box is checked; otherwise, press <Enter>.

(25)

Third-Party Designee's ID Number

ID#

<Enter>

Enter the Third-Party Designee's PIN number.
Refer to IRM 3.24.38.3.4.14.19, Third Party Designee ID Number, for complete instructions.

(26)

Preparer's PTIN

PTIN

<Enter>

Enter the Paid Preparer's PTIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(27)

Preparer's EIN

PEIN

<Enter>

Enter the Preparer's EIN.
Refer to IRM 3.24.38.3.4.14.20, Preparer's SSN, Firm's EIN and Preparer's TIN, for complete instructions.

(28)

Preparer's Telephone Number

TEL#

<Enter>

Enter the Preparer's telephone number.

1. If the number has 11 digits and the first digit is 1, skip the first digit and input the remaining 10 digits.

2. For all other 11-digit numbers, numbers with more or less than 10 digits, or illegible numbers; press <Enter>.

Refer to IRM 3.24.38.3.4.14.21, Telephone Numbers, for complete instructions.

(1)

Section Number

SECT:

<Enter>

Press <Enter> if already present on the screen; otherwise, enter "04".

(2)

Adjustments to Employer and Employee Railroad Retirement Taxes Based on Compensation

L14

<Enter>
Minus <->

Enter the amount from Line 14.

(3)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation

L16

<Enter>

Enter the amount from Line 16.

(4)

Nonrefundable Portion of Employee Retention Credit

L17A

<Enter>

Enter the amount from Line 17a.

(5)

Nonrefundable Portion of Credit for Qualified Sick and Family Leave Compensation Taken After March 31, 2021

L17B

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Enter the amount from Line 17b.

(6)

Nonrefundable Portion of COBRA Premium Assistance Credit

L17C